Study And Risk Assessment Of Cardiovascular Disease Risk Factors In Children And Adolescents With Different Physical Activity

Objective The prevalence of obesity,high blood pressure,high blood sugar and abnormal blood lipids among the groups was compared with different body activity（PA）groups to understand the detection of cardiovascular disease risk factors and the effect of physical activity on children and adolescents in Ningxia.The correlation between PA,obesity and central obesity and cardiovascular risk was discussed according to the evaluation of cardiovascular risk in children and adolescents,such as metabolic syndrome,high CVD（cardiovascular diseases）risk score and CVD risk factor aggregation.Comparing children and adolescents of different genders at different PA levels,the indentation values of cardiovascular risk were screened with body mass index（BMI）,waist circumference（WC）,waist-to-hip ratio（WHR）and waist-height ratio（WHtR）,respectively,to verify the judgment of the screening ability of the four indicators in the study.It provides reference for the prevention and control of cardiovascular disease in children and adolescents.Methods By using the method of stratified random group sampling,15 primary schools,junior high schools and high schools were randomly selected in Ningxia City,and the whole group sampling was carried out by grade level and class unit.A total of5,664 baseline samples（2,792 boys and 2,872 girls）were selected for questionnaire surveys and physical measurements,and 2,074 serum samples were taken for laboratory testing.The CVD risk evaluation was carried out by metabolic syndrome,high CVD risk score and CVD risk factor aggregation.By comparing BMI,WC,WHR,WHtR screening metabolic syndrome,high CVD risk score,and the effect of CVD risk factor aggregation by the ROC curve and the integral sex below the curve,the appropriate cut-point values for each indicator screening were determined by the Youden index.Result 1.The detection rates of obesity and central obesity in children and adolescents were 6.1%and 22.4%respectively,while the high blood pressure,high blood sugar,high TC,high TG,low HDL and high LDL were 26.6%,0.4%,2.1%,21.7%,0.6%,32.0%;low PA,metabolic syndrome,high CVD risk score,CVD risk factor aggregation detection rate was 19.5%,7.3%,15.9%,10.9%respectively.The detection rates of obesity,central obesity,metabolic syndrome,high CVD risk score and CVD risk factors aggregation are greater for boys than for girls.Only girls with low PA detection rates were higher than boys.2.The detection rates of Obesity,central obesity,high blood pressure,high blood sugar,high TC,high TG,high LDL,low HDL,metabolic syndrome,high CVD risk score and CVD risk factor aggregation in the group of low PA were 5.3%,20.3%,25.4%,0.6%,1.7%,25.7%,0.0%,28.6%,6.5%,17.9%,10.9%.While the detection rates in the group of normal PA were 6.1%,24.4%,27.8%,0.6%,2.2%,22.6%,0.6%,34.3%,6.5%,16.5%and 11.0%,respectively.There was no difference between the detection rates of risk factors under different PA groups（P>0.05）,except for central obesity.3.There was a positive correlation between the three cardiovascular risks（P<0.05）.The correlation coefficient between metabolic syndrome and high CVD risk score was0.470,the correlation coefficient between metabolic syndrome and CVD risk factor aggregation was 0.802,and the correlation coefficient between high CVD risk score and CVD risk factor aggregation was 0.590.4.The correlation of obesity and metabolic syndrome,obesity and high CVD risk score,obesity and CVD risk factor aggregation were positive（correlation coefficients were0.305,0.264,0.228,P<0.01）.The correlation of centra obesity and metabolic syndrome,centra obesity and high CVD risk score,centra obesity and CVD risk factor aggregation were positive（correlation coefficients were 0.489,0.310,0.341,P<0.01）.There was no correlation between PA and the three risks（P>0.05）.5.The risk of metabolic syndrome was 4.536 times in the group of obesity and normal PA compared to the group of normal weight and PA（OR=4.536,95%CI:2.051-10.032）.The risk of high CVD risk score was 4.851 times in the group of obesity and normal PA compared to the group of normal weight and PA（OR=4.851,95%CI:2.728-8.628）.The risk of CVD risk factor aggregation was 2.626 times in the group of obesity and normal PA compared to the group of normal weight and PA（OR=2.626,95%CI:1.263-5.462）.The risk of high CVD risk score was 3.645 times in the group of central obesity and normal PA compared to the group of normal waist circumference and PA（OR=3.645,95%CI:2.428-5.473）.The risk of CVD risk factor aggregation was 4.313 times in the group of central obesity and normal PA compared to the group of normal waist circumference and PA（OR=4.313,95%CI:2.534-7.341）.6.The area under the ROC curve of each indexs screening the metabolic syndrome in the group of normal PA is as follows:boys,AUC_WC>AUC_WHtR>AUC_WHR>AUC_BMI;girls,AUC_WHtR>AUC_WC>AUC_WHR>AUC_BMI.The area under the ROC curve of each indexs screening the high CVD risk scores in the group of normal PA is as follows:boys,AUC_WC>AUC_BMI>AUC_WHtR;girls,AUC_BMI>AUC_WC>AUC_WHtR>AUC_{WH R}.The area under the ROC curve of each indexs screening the CVD risk factor aggregation in the group of normal PA is as follows:boys,AUC_WC>AUC_WHtR>AUC_BMI;girls,AUC_BMI>AUC_WC>AUC_WHtR>AUC_WHR.7.The area under the ROC curve of each indexs screening the metabolic syndrome in the group of low PA is as follows:boys,AUC_WC>AUC_WHtR;girls,AUC_BMI=AUC_WC>AUC_WHtR>AUC_WHR.The area under the ROC curve of each indexs screening the high CVD risk scores in the group of low PA is as follows:boys,AUC_BMI>AUC_WC>AUC_WHtR;girls,AUC_WC>AUC_WHtR>AUC_BMI>AUC_WHR.The area under the ROC curve of each indexs screening the CVD risk factor aggregation in the group of low PA is as follows:boys,AUC_WHtR>AUC_WC;girls,AUC_WC>AUCBMI>AUCWHR>AUCWHtR.Conclusion 1.There were gender differences in height,weight,body mass index,waist circumference,hip circumference,waist-hip ratio,waist-height ratio,diastolic blood pressure,systolic blood pressure,triglycerides,HDL,moderate physical activity,high physical activity,and moderate to high physical activity.2.Obesity and central obesity will increase the risk of cardiovascular disease.3.It is particularly important to control central obesity,high TG,and low HDL in children and adolescents.4.Girls are more likely than boys to have CVD.5.The group of normal PA:The ability of WC screening metabolic syndrome,high CVD risk score,CVD risk factor aggregation are better than other indicators in boys.The ability of WHtR screening metabolic syndrome is better than other indicators in girls.The ability of BMI screening high CVD risk score,CVD risk factor aggregation are better than other indicators in girls.6.The group of low PA:The ability of WC screening metabolic syndrome is better than other indicators in boys.The ability of BMI screening high CVD risk score is better than other indicators in boys.The ability of WHtR screening CVD risk factor aggregation is better than other indicators in boys.The ability of WC screening metabolic syndrome,high CVD risk score,CVD risk factor aggregation are better than other indicators in girls.